West blast, COVID-19 reviews rapid changes in healthcare areas

The health district hired the Litaker Group to conduct studies and evaluations of the health district’s performance during the pandemic, and district staff conducted its own disaster study at West. Staff presented the findings to the board on Wednesday.

The Litaker Group, which has done follow-up reviews for other Texas health districts, such as Austin Public Health, studied the response to the pandemic announced in March 2020. The firm surveyed 96 health district employees and community leaders, conducted 16 individual interviews and held group feedback sessions with another 39 people.

The most glaring weakness Litaker identified in the pandemic response was in the execution of incident command duties, said Stephanie Alvey, Waco-McLennan County deputy health director.

“To respond to this finding, we have expanded command post training and exercises to include all of our personnel,” she said in an interview Thursday.

“Prior to COVID, when we were conducting incident command training and exercises, they only involved about a third of our staff.”

The county found that when it had to staff an incident command and perform normal duties for months, everyone ended up rotating through the emergency response operations center, she said.

“So now that we have exercises and incident command training, we’re getting everybody involved,” Alvey said.

At the same time, Littaker found that partnerships developed before and after the pandemic began helped the district’s efficiency. The mass vaccination clinics in the area have been deemed a success and Alvi said the planning and exercises for it have paid off. The call center and coordination efforts also received high marks.

Alvi said the systems and procedures created and implemented while in charge made the call center work and brought different organizations in the health district out of their “silos” to work together.

Other areas for improvement include using technology and responding to disproportionately affected populations.

The health district needs to improve its use of data and analytics, as well as use technology in meeting registrations, Alvey told the board Wednesday. And now that officials know about the disproportionately affected population, they can understand the differences and do a better job predicting resource requirements for the next incident.

After Alvey’s presentation, Dr. Jackson Griggs, CEO of Waco Family Medicine, who chaired Wednesday’s meeting, commended Health District Director LaShonda Mulry-Horn for efficiently organizing the district’s response activities since she became director in the middle of the pandemic in January 2021. He also applauded the spirit of collaboration among staff and partners.

“What was heroic was the people: the humility, the learning and the cooperation, rather than the defense of the territory,” Griggs said. “We could have seen more deaths without that team and how well they worked together.”

The follow-up health assessment of the deadly explosion at the West Fertilizer Co. plant. on April 17, 2013, found a continuing need for psychiatric services for those who witnessed the disaster, senior epidemiologist Vaidehi Shah told the board Wednesday. The explosion killed 15 people, most of whom were first responders, and left many families homeless.

In fact, both the disaster in the West and the pandemic have shown the importance of mental health services, Mulry-Horn said by phone Thursday.

“We added a Mental Health Coordinator position so we can better understand the services available in the community and also direct our clients who need those services to the providers best suited to provide the treatment or counseling they may need,” Mulry-Horn said.

For the follow-up health assessment in West, the county sent out postcard inquiries for online surveys and conducted in-person interviews, Shah told the board Wednesday. These methods resulted in 372 completed surveys among a population of approximately 2,500 in the 2020 census.

The surveys don’t account for people who have moved, and many of the addresses the health district has in its records haven’t been updated, Shah said.

In addition to finding mental health needs, the survey found joint and mobility problems in the general population.

Because the study did not measure the age or gender of the respondents, it cannot determine the cause of these physical problems or whether they are age-related.

Funding for the new mental health coordinator position came from a special staffing grant from the U.S. Centers for Disease Control and Prevention, administered through the Texas Department of State Health Services, Mulry-Horn said.

Malrey-Horne said the special staffing grant allows health districts across the country to identify staffing needs based on the population they serve and hire for those needs. The grant will continue for another four years.